PC1029: Pediatric Emergency Medicine Fellow Advocacy Curriculum Assessment

Background: Advocacy is an essential skill for pediatric emergency medicine (PEM) physicians to improve child health at the levels of the individual patient, community, and nation. Advocacy curricula for PEM fellows have not been previously evaluated or disseminated. We aimed to develop and evaluate a curriculum to teach core advocacy skills to PEM fellows through didactics and longitudinal fellow-driven group projects.

Methods: We developed an advocacy curriculum using the Kern and Thomas six-step approach to curriculum development. PEM fellows completed an optional, anonymous survey at the beginning of the 2021-2022 academic year. The survey consisted of a self-assessment of advocacy attitudes, knowledge, and skills using a 5-point Likert scale; self-reported participation in advocacy activities; and free-response questions to gauge advocacy knowledge. We used the pre-survey as a targeted needs assessment to refine the goals and objectives of the curriculum. Fellows completed the same survey at the culmination of the academic year, after completion of the advocacy curriculum. We used two-sided paired T-tests to compare pre- and post-curriculum survey responses.

Results: We received pre- and post-curriculum survey responses from 87.5% (n=7) and 75% (n=6) of PEM fellows respectively. Attitudes towards advocacy were positive before and after the curriculum (mean Likert responses 4.63, 4.63, p = 1.0). Self-assessment of advocacy knowledge increased significantly, from a mean Likert response of 4.25 to 4.92 (p = 0.03). The mean Likert response for self-assessment of advocacy skills was 3.63 before and 4.33 after the curriculum (p = 0.06) (Figure 1). Fellows reported a significant increase in participation in advocacy activities over the previous 12 months, including legislative advocacy, radio or television interviews, and use of social media (Figure 2), from 4.17 mean activities before, to 11.50 mean activities after the curriculum (p = 0.02). Scores on a free-response assessment gauging the knowledge of local government officials remained stable with a mean score of 53.3% before and 76.6% after the curriculum (p = 0.06). However, fellows could list more hospital-wide advocacy initiatives after the curriculum with the mean number of initiatives listed increasing from 0.50 to 1.67 (p < 0.001).

Conclusion: Self-reported advocacy knowledge, participation in advocacy activities, and knowledge of hospital-wide advocacy initiatives increased after participation in the advocacy curriculum, while attitudes towards advocacy remained positive. Implementation of a specialized advocacy curriculum may support PEM fellows’ professional development as child health advocates.